| NPI | 1619138385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1478) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2006031019) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2008-06-24 |